INTERVIEW: NTU’s Yang cautious on doctors’ inclusion in labor act

As the Ministry of Health and Welfare considers extending the Labor Standards Act to cover doctors as a solution to the shortage of medical staff in Taiwan, National Taiwan University president Yang Pan-chyr, who is also a doctor, said in an interview with Liberty Times (the sister newspaper of the Taipei Times) reporter Jennifer Huang that amending the act without an established system in place might cause the situation to deteriorate, making doctors and patients the victims

National Taiwan University president Yang Pan-chyr gestures during an interview with the Taipei Times’ sister newspaper, the Liberty Times, on Sept 15.

Photo: Chu Pei-hsiung, Taipei Times

LT: What do you think are the most serious problems facing Taiwan’s medical staff?

Yang Pan-chyr (楊泮池): Doctors are dissatisfied with their long work hours, the imbalance between work and leisure, the non-ideal wages-to-work ratio, lack of guarantees on occupational hazards and subsequent lawsuits.

To make changes to all these things, our medical field truly needs some reforms.

I support the motion to cut down on the 88-hour workweek that is currently employed. Doctors should not have to work such long hours, as tiredness diminishes the quality of medical services. There really is a need for more reasonable work hours as well as work environment regulations.

According to a study on work hours for Taiwan’s 40,000 medical staff, surgeons had the highest number of work hours — at a maximum of 15 hours per day (based on a five-day workweek) — followed by general medicine, obstetrics and gynecology, general pediatrics and emergency room doctors.

All five divisions are important medical fields, and all five are facing severe personnel shortages. These divisions are all high-stress and high-risk, both in terms of their job and in terms of legal troubles that come with the job.

Many doctors are more willing to transfer into low-risk divisions, such as cosmetic surgery.

Consequently, in all five fields, and more so in rural hospitals, people are working longer hours because of staff shortages.

LT: The plan to extend the Labor Standards Act (勞動基準法) to cover doctors was opposed by the Ministry of Health and Welfare and the Ministry of Labor during the former Chinese Nationalist Party (KMT) administration, yet now the KMT, as an opposition party, is looking to expedite the inclusion of doctors under the act. What changes to the medical environment are experts worried about?

Yang: The [planned] inclusion of doctors under the Labor Standards Act would not necessarily resolve the sweatshop conditions doctors are working under. Most problems should be resolved by fine-tuning existing measures, such as the National Health Insurance (NHI) program payout scheme, the establishment of a medical dispute law and occupational insurance for doctors.

If we are unable to attain solutions based on our problems, and also fail to plan for expansive set measures, then including doctors under the act would only serve to shorten doctors’ work hours on paper while creating more problems.

The act’s regulations on work hours are too uniform and do not take into consideration whether individuals are interns or visiting staff. If, for example, a resident doctor is eligible under the act, their workweek would be capped at 40 hours, with an average eight-hour day, or 12-hour maximum, and other limitations placed on them.

If doctors who attend to patients or perform surgery are limited to eight-hour workdays, the nation would see a serious impact on the quality of medical provisions.

A doctor’s job is to save lives and treat illnesses; however, these things do not happen at fixed times. Imagine a doctor that is supposed to operate on two patients, but is forced to leave in the middle of the operation because they need to clock out of work; is the hospital going to have doctors take turns at the operation table?

Additionally, the reduced work hours for doctors would also see fewer people attended to. Will patients accept it if hospitals were to announce a decreased service capacity and ask patients to vacate their sick beds? The situation would also cause longer waiting times for patients, which would directly impact citizens’ rights to receive medical treatment.

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